Vanderbilt Heart and Vascular Institute recently performed its 100th transcatheter aortic heart valve-replacement (TAVR) on 91-year-old Murline Westover from Lavinia, Tenn.
Vanderbilt performed its first TAVR in July 2011 when it embarked on the clinical trial of Medtronic’s CoreValve.
Vanderbilt is one of a few medical centers in the country to offer both the CoreValve and the Edwards SAPIEN valve, artificial valves designed to replace a patient’s defective one without opening the chest.
“To reach this milestone in just one year is a tremendous accomplishment. We have clearly established Vanderbilt as a leader in this minimally invasive procedure for valve replacement,” said John Byrne, M.D., William S. Stoney Professor and chair of the Department of Cardiac Surgery.
Like Westover, nearly 200,000 people each year are diagnosed with aortic stenosis, a narrowing of the main valve allowing blood to leave the heart. Seventy-five percent of those diagnosed are deemed high risk or ineligible for open-heart surgery — the standard therapy.
“There are no other options for this group of patients,” said David Zhao, M.D., director of the Cardiovascular Catheterization Lab and Interventional Cardiology. “Our referring physicians know they can send these patients to us and they will be in capable, experienced hands.”
The CoreValve, which is made from porcine pericardial tissue with an expandable frame, was implanted in Westover.
Using transcatheter aortic valve implantation, the artificial valve is attached to a wire frame and guided by catheter through the groin to the heart.
Once inserted inside the defective valve, the wire frame expands, allowing the new aortic valve to open and immediately begin to pump blood.
“Maybe this will encourage somebody else to have this procedure and help them out, too,” said Westover, who was self-sufficient until last year when the stenosis took a toll on her health. “I can finally breathe again,” she said the day after surgery.
Compared to the four to six hours typical in open-heart surgeries, this procedure calls for a smaller incision and takes about 90 minutes to complete.
Byrne said the non-surgical valve replacement technique will become a standard therapy in the next three to five years.
He attributes the rapid success of the TAVR program to the teamwork, shared vision and goals between Vanderbilt’s cardiologists and cardiac surgeons, established with the opening of the hybrid OR in 2005, which has eased the way for the TAVR program.
The TAVR team is comprised of Zhao, Byrne, Joseph Fredi, M.D., Mark Robbins, M.D., Marshall Crenshaw, M.D., Steve Ball, M.D., Lisa Mendes, M.D., Mike Baker, M.D., Sonia Scalf, R.N.; Margaret Morrison, NP; Deborah Payne, NP, Carol Watts, R.N., Mary Lou Haynes, R.N., Lynn Blair-Anton, R.N., and a team of cardiac anesthesiologists.
